Assisted Reproduction Techniques for HIV_HCV_HBV Serodiscordant Couples: 4 Years of Experience

Abstract

ObjectiveOur aim was to evaluate the results of our assisted reproduction programme for these couples and to develop adequate strategies for their management. Human Inmunodeficiency Virus (HIV) and Hepatitis C and B virus (HCV, HBV) serodiscordant couples with the male infected can be helped to have children minimizing the transmission risk.DesignRetrospective review in private setting.Materials and methodsMembers of serodiscordant couples: a. HIV positives males attending our Centre for sperm wash and assisted reproduction, b.HCV positive and HBV positive males needing assisted reproduction for infertility provided 256 semen samples for sperm wash. Before artificial insemination (AI) or Intracitoplasmatic Sperms Injection (ICSI) treatment, semen was confirmed to be negative for viral presence by Polimerase Chain Reaction (PCR) after the sperm wash (Limit 50 cop/ml).ResultsA total number of 149 cycles were carried out, 53 ICSIs and 96 AIs. Thirty-one pregnancies were obtained. The pregnancy rates of ICSI were 26.6% in HBV, 21.42% in HCV and 20% in HIV. For IA, the pregnancy rates obtained were as follow: 18.18% in HBV, 14.58% in HCV and 27,02% in HIV. Regardless of the type of infection, no differences were found in semen quality and embryos obtained. No seroconversion was detected in the patient’s follow-up.ConclusionsTo date, sperm wash, PCR and AI or ICSI are an effective procedures that avoid HIV, HBV and HCV transmission with reasonable pregnancy rates. Although a few assisted reproductive technique cycles were performed for this indication without contamination, it is still too early to demonstrate that this technology is fully safe. Many questions remain unresolved. ObjectiveOur aim was to evaluate the results of our assisted reproduction programme for these couples and to develop adequate strategies for their management. Human Inmunodeficiency Virus (HIV) and Hepatitis C and B virus (HCV, HBV) serodiscordant couples with the male infected can be helped to have children minimizing the transmission risk. Our aim was to evaluate the results of our assisted reproduction programme for these couples and to develop adequate strategies for their management. Human Inmunodeficiency Virus (HIV) and Hepatitis C and B virus (HCV, HBV) serodiscordant couples with the male infected can be helped to have children minimizing the transmission risk. DesignRetrospective review in private setting. Retrospective review in private setting. Materials and methodsMembers of serodiscordant couples: a. HIV positives males attending our Centre for sperm wash and assisted reproduction, b.HCV positive and HBV positive males needing assisted reproduction for infertility provided 256 semen samples for sperm wash. Before artificial insemination (AI) or Intracitoplasmatic Sperms Injection (ICSI) treatment, semen was confirmed to be negative for viral presence by Polimerase Chain Reaction (PCR) after the sperm wash (Limit 50 cop/ml). Members of serodiscordant couples: a. HIV positives males attending our Centre for sperm wash and assisted reproduction, b.HCV positive and HBV positive males needing assisted reproduction for infertility provided 256 semen samples for sperm wash. Before artificial insemination (AI) or Intracitoplasmatic Sperms Injection (ICSI) treatment, semen was confirmed to be negative for viral presence by Polimerase Chain Reaction (PCR) after the sperm wash (Limit 50 cop/ml). ResultsA total number of 149 cycles were carried out, 53 ICSIs and 96 AIs. Thirty-one pregnancies were obtained. The pregnancy rates of ICSI were 26.6% in HBV, 21.42% in HCV and 20% in HIV. For IA, the pregnancy rates obtained were as follow: 18.18% in HBV, 14.58% in HCV and 27,02% in HIV. Regardless of the type of infection, no differences were found in semen quality and embryos obtained. No seroconversion was detected in the patient’s follow-up. A total number of 149 cycles were carried out, 53 ICSIs and 96 AIs. Thirty-one pregnancies were obtained. The pregnancy rates of ICSI were 26.6% in HBV, 21.42% in HCV and 20% in HIV. For IA, the pregnancy rates obtained were as follow: 18.18% in HBV, 14.58% in HCV and 27,02% in HIV. Regardless of the type of infection, no differences were found in semen quality and embryos obtained. No seroconversion was detected in the patient’s follow-up. ConclusionsTo date, sperm wash, PCR and AI or ICSI are an effective procedures that avoid HIV, HBV and HCV transmission with reasonable pregnancy rates. Although a few assisted reproductive technique cycles were performed for this indication without contamination, it is still too early to demonstrate that this technology is fully safe. Many questions remain unresolved. To date, sperm wash, PCR and AI or ICSI are an effective procedures that avoid HIV, HBV and HCV transmission with reasonable pregnancy rates. Although a few assisted reproductive technique cycles were performed for this indication without contamination, it is still too early to demonstrate that this technology is fully safe. Many questions remain unresolved.